Investigating Thirst Dimensions in Heart Failure Patients Using the Theory of Unpleasant Symptoms: A Cross-Sectional Study

Arash  Vedad; MohamadAli  Akbarzadeh; Payam  Emami; Nana  Waldréus; Mahsa  Boozari Pour

doi:10.18502/jthc.v19is1.18473

Arash Vedad Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
MohamadAli Akbarzadeh Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Payam Emami Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nana Waldréus Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Mahsa Boozari Pour Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jthc.v19is1.18473

Keywords: Thirst, Heart Failure, Symptoms

Abstract

Background: Thirst, a distressing complication in heart failure (HF) patients, arises from factors such as vasoconstriction in the salivary glands, alterations in the sympathetic nervous system, fluid restriction, nursing care practices, and pharmacotherapy. This study aimed to explore the dimensions of thirst in HF patients using the Theory of Unpleasant Symptoms (ToUS).

Methods: A descriptive cross-sectional study was conducted on 217 HF patients admitted to hospitals affiliated with Shahid Beheshti University of Medical Sciences, namely Imam Hossein, Luqman Hakim, and Shahid Modares in Tehran, Iran, from May through November 2020. Participants were selected through purposive sampling based on inclusion criteria. Data were collected using the Demographic Survey Form (DSF), Thirst Intensity Visual Analogue Scale (TI-VAS), Thirst Frequency Scale (TFS), and Thirst Distress Scale (TDS). Descriptive and analytical statistics were employed for data analysis using SPSS (version 20).
Results: The mean ± standard deviation scores for thirst intensity and thirst distress were 47.53±26.37 (moderate level) and 25.92±8.13 (high level), respectively. A significant proportion of patients (35.9%) experienced high levels of thirst distress. Additionally, 61% of participants reported feeling thirsty almost daily over the past month, with thirst persisting throughout the day. Key predictors of thirst intensity and distress included educational level; HF class; living conditions; fluid restriction; use of angiotensin-converting enzyme inhibitors, β-blockers, aldosterone antagonists, and diuretics; and the presence of diabetes.

Conclusion: Given the high prevalence and distressing nature of thirst in HF patients, nurses should prioritize assessing thirst during care delivery. Identifying contributing factors and predicting thirst intensity during patient history-taking can enhance management strategies.